A Rare Case of Acute Myocardial Infarction Due to Coronary Artery Dissection and Heparin-Induced Thrombocytopenia
A Rare Case of Acute Myocardial Infarction Due to Coronary Artery Dissection and Heparin-Induced Thrombocytopenia
Nikath Nasreen N, Kaavya M, Logeswari B M, Blessy John
Journal of Angiotherapy 5(2) https://doi.org/10.25163/angiotherapy.52621622920201221
Submitted: 30 November 2021 Revised: 11 December 2021 Published: 20 December 2021
The patient’s acute coronary syndrome likely resulted from the combination of endothelial disruption from coronary artery dissection in the context of chest trauma, compounded by acute thrombosis, coronary occlusion, and subsequent myocardial infarction due to heparin-induced thrombocytopenia.
Abstract
Background: Although both coronary artery dissection and heparin-induced thrombocytopenia may provoke myocardial infarction, it is extremely rare for both conditions to develop simultaneously in a single patient. We report a case of a 69-year-old woman who sustained a head-on motor vehicle accident with associated chest trauma. Methodology: During a subsequent hospitalization, she was exposed to subcutaneous heparin and developed significant thrombocytopenia. Shortly after that, she was represented with acute myocardial infarction. Result: Coronary angiography revealed a spiral dissection with superimposed thrombosis within the right coronary artery, while laboratory testing confirmed the diagnosis of heparin-induced thrombocytopenia. She was treated with catheter-based thrombectomy and adjunctive direct thrombin inhibitor therapy, followed by three months of systemic anticoagulation with warfarin. Conclusion: To our knowledge, this represents the first published case of a native vessel myocardial infarction due to the combination of coronary artery dissection and heparin-induced thrombocytopenia.
Keywords: myocardial infarction, coronary artery dissection, and heparin-induced thrombocytopenia.
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